Allogeneic hematopoietic stem cell transplantation could improve survival for pure CBF-AML patients with minimal residual disease positive after the second consolidation

The role of MRD-directed risk stratification strategy for core binding factor acute myeloid leukemia (CBF-AML) patients with favorable risk genetics is still unknown. We retrospectively analyzed the clinical outcomes of 148 pure CBF-AML patients with first complete remission including MRD positive (n = 69) and MRD negative (n = 79) after two courses of consolidation from January 2009 to December 2018 in our center. We found that MRD positive after 2 courses of consolidation significantly influenced OS (5-year: 59%), PFS (5-year: 36%) and CIR (5-year: 58%) in favorable-risk CBF-AML patients with CR1. It was worth noting that the MRD status after two courses of consolidation might be the best timing for treatment choice and allo-HSCT was a promising treatment for favorable-risk CBF-AML patients with MRD positive after the second consolidation.

Automated summary

The study found that MRD positivity after two consolidation courses significantly affects overall survival, progression-free survival, and cumulative incidence of relapse in patients with favorable-risk CBF-AML in first complete remission. Moreover, the MRD status after two consolidation courses may be the optimal timing for treatment choice, and allo-HSCT is a promising option for favorable-risk CBF-AML patients who are MRD positive after the second consolidation.